Shanghai Cohort Study

Funded Since: 1987Funding Source: NCI Extramural Program (Epidemiology and Genomics Research Program, Division of Cancer Control and Population Sciences; CA144034)Year(s) of Enrollment: 1986-1989

The Shanghai Cohort Study consists of 18,244 men in Shanghai, China, assembled during 1986-1989 when subjects were between the ages of 45 and 64 years. At recruitment, all cohort members provided detailed dietary and medical histories as well as blood and urine specimens. In the follow-up of 2000-2001, buccal cells were collected from 13,815 original cohort participants (92% of all surviving cohort members).

The cohort has been followed for the occurrence of cancer, death, and major health outcomes (e.g., cardiovascular disease, diabetes) through routine ascertainment of new cases from the population-based Shanghai Cancer Registry and Shanghai Vital Statistics Units, and annual visits to all known surviving cohort members. In addition to cohort analyses to examine the impact of cigarette smoking, alcohol intake, and certain dietary factors on mortality and morbidity, a series of nested case-control studies has been conducted to further elucidate the role o diet-related factors using biomarkers as more specific and objective measures for exposure in the etiology of cancer. Furthermore, the interplay of genetic and dietary factors in influencing cancer risk has been examined among the cohort participants.

This prospective cohort study has contributed a wealth of knowledge on the role of diet-related and other environmental exposures, as well as genetic factors in the etiology of cancer. More than 35 peer-reviewed articles have emanated from this study. Significant scientific contributions include the:

first evidence in a non-Occidental population that smoking is a strong predictor of overall mortality and cancer mortality (JAMA. 1996 Jun 5;275(21):1646-50);

first demonstration in a non-Occidental population that moderate alcohol intake is associated with the lowest risk of overall mortality (i.e., an U-shaped drinking-mortality curve) (BMJ. 1997 Jan 4;314(7073):18-23);

first evidence that a history of hypertension is a strong predictor for risk of stroke mortality in this high-risk Chinese population (Circulation. 1997 Jul 1;96(1):50-5;

first demonstration in a non-Occidental population that either low or high body mass index (BMI) is associated with increased total mortality (a U-shaped BMI-mortality curve) (Int J Epidemiol. 1998 Oct;27(5):824-32);

first direct evidenc that dietary isothiocyanates (ITCs) protect against the development of lung cancer in humans. The chemopreventive effect is modified by genetic variation in glutathione S-transferases (GSTs) that favor rapid elimination of these compounds (Lancet. 2000 Aug 26;356(9231):724-9);

first evidence in a non-Occidental population that intake of fish or omega-3 fatty acids is associated with reduced risk of fatal myocardial infarction (Am J Epidemiol. 2001 Nov 1;154(9):809-16);

first demonstration in a non-Occidental population that insulin-like growth factors (IGF) and their binding proteins are associated with risk of colorectal and lung cancers (Br J Cancer. 2001 Nov 30;85(11):1695-9; J Natl Cancer Inst. 2002 May 15;94(10):749-54);